UROLOGY 4 & 5 Flashcards
Is lower urinary tract disease more local or systemic?
local
What is pollakuria?
Frequent urination in small amounts [different from polyuria]
What are the common presentations of animals with LUTD?
- Pollakiuria
- Stranguria
- Dysuria
- Periuria
- Haematuria
- Urinary retention
- Incontinence
What key diagnostic steps are essential for LUTD?
- History
- Physical Exam [palpate bladder, chekc urethral patency, rectal exam]
- Urinalysis [dipstick, sediment, culture]
- Imaging
- Neurological Exam [anal tone, reflexes, bladder function]
What are the causes of dysuria?
- Inflammation
- Obstruction (intra- or extraluminal)
*neuro - Neurological
What is cystitis?
Inflammation of the bladder, , often due to ascending infection
What are 3 common pathogens associated with bacterial cystitis?
*faecal pathogens
*E.Coli
*enterococcus
What are the predisposing factors for bacterial cystitis?
- Dilute urine
- Incontinence
- Urine retention
- Catheter use
- Immunocompromise
- Damaged urothelium
What is the treatment for bacterial cystitis?
Empirical antibiotics based on gram +/-
ideally narrow spectrum based on sensitivity results.
What characterizes Feline Idiopathic Cystitis (FIC)?
Sterile inflammation, a diagnosis of exclusion.
What are the predisposing factors for FIC?
- Young cats
- Males
- Neutered
- Multi-cat households
- Nervous/anxious personality
- Obesity
- Indoor environment
- Dry food
- Black & white colouration
What is the treatment approach for FIC?
Multimodal, including analgesia, antispasmodics, increased water intake, environmental modifications, and stress reduction.
What are the emergency considerations for Feline Urethral Obstruction?
Requires immediate attention due to the risk of post-renal azotemia and hyperkalemia.
What is the cause of feline urethral obstructions?
block/stone -> inability to urinate ->bladder distension ->muscle spasms
What are the clinical signs of Feline Urethral Obstruction?
- Straining to urinate
- Obtunded or bradycardic if hyperkalemic
- Enlarged, turgid bladder eliciting pain on palpation
What is the treatment for Feline Urethral Obstruction?
- Stabilize with IV fluids
- Analgesia
- Urinary catheter placement
- Decompressive cystocentesis if needed
*antispasm medication once spabalised
[retrograde hydropulsion if urolith?]
What is polypoid cystitis?
A focal, raised form of cystitis resulting from chronic inflammation.
Where is polypoid cystitis usually located?
cranial bladder wall
How is polypoid cystitis diagnosed?
catheter in bladder, suction chunk of polyp, cytology
What is urinary incontinence?
Involuntary urination
What are some neurological factors to be assessed in cases of urinary incontinence?
anal tone, perineal reflex, bulbocavernosus reflex, bladder expression
What are the types of urinary incontinence?
- Upper Motor Neuron
- Lower Motor Neuron
- Sphincter Mechanism Incompetence (USMI)
describe upper motor neuron urinary incontinence:
large/small bladder
soft/tense bladder
easy/difficult to express
large
tense
difficult to express
describe lower motor neuron urinary incontinence:
large/small bladder
soft/tense bladder
easy/difficult to express
large
soft
easy to express
What defines urinary sphincter mechanism incompetence?
Adrenaline acts on estrogen receptors, happens when they are sleeping.
What is an ectopic ureter?
Congenital anomaly where ureters open caudally rather than opening in the bladder.
What are two types of ectopic ureter?
intramural or extramural
What is general diagnosis and treatment of ectopic ureter?
diagnosis: contrast study
treatment: if intramural: laser ablation
if extramural: surgical tx
Benign prostatic hyperplasia is driven by which hormone?
androgen
What are the clinical signs of benign prostatic hyperplasia?
- Dysuria
- Haematuria
- Penile discharge
- Tenesmus
- Enlarged symmetrical non-painful prostate
What is the treatment for benign prostatic hyperplasia?
- Surgical castration
- Osaterone acetate
- Delmadinone acetate
- Deslorelin
- Finasteride
What is a frequent cause of prostatitis?
ascending bacterial infection
What are clinical signs of prostatis?
pain, stilted gait, systemically unwell, cystitis, penile discharge/haemorrhage
What is the treatment of prostatitis?
antibiotics (ensure crosses blood-prostate barrier if chronic)
castration
What are 4 “other prostatic diseases”?
squamous metaplasia
prostatic carcinoma
prostatic abscess
prostatic/paraprostatic cysts
What is urolithiasis?
stones in lower urinary tract
What are the 4 parts of urolith formation?
nidus [bacteria, epithelial cells, foreign material]
nucleus
stone
outer surface crystals
What are treatment options for uroliths?
shock wave therapy
endoscopic nephrolithotomy
stent placement
surgical intervention
What are the simmilarities and differences in the effects of ureteroliths and urethroliths?
ureteroliths: big/little kidney syndrome
urethroliths: uroabdomen
both: post-renal azotaemia, incontinence, pain
What is the treatment strategy for urolithiasis?
- Medical management (dietary changes, medications)
- Surgical intervention (removal or bypass procedures)
What are nephroliths?
Kidney stones, often incidental findings, that can cause hematuria, renal pain, or obstruction.
What are the management options for urethroliths?
- Catheter placement
- Retrograde hydropulsion
- Urethrotomy
- Urethrostomy
- Laser lithotripsy
What defines cystoliths?
Bladder stones
What are the types of uroliths?
- Struvite
- Calcium oxalate
- Urate
- Cystine
- Xanthine
- Silicate
What is the composition of struvite stones?
MGg (magnesium), NH3 (ammonium), PO4 (phosphate)
What is a predisposing factor of struvite stones?
UTI.
Which types of stones cannot dissolve medically?
calcium oxalate
Which type of stones cannot be seen in radiographs?
cystine
xanthine
urate
What medication can prevent the formation of urate stones?
allopurinol treatment
What breed is predisposed to xanthine stones?
cavaliers
What is the shape of cystine stones?
Hexagonal shape; cannot be seen in radiographs.
What is a common treatment for urate stones?
Treat infection if present and provide a low protein diet.
True or False: Urolithiasis often recurs.
True
When giving allopurinol to prevent uric acid buildup, what needs to be supplemented?
low purine diet in order to prevent buildup of xanthine
